Maternal plasma levels of endothelial dysfunction mediators including AM, CGRP, sICAM-1 and tHcy in pre-eclampsia.

BACKGROUND Pre-eclampsia is a pregnancy-specific disorder of widespread vascular endothelial dysfunction that occurs after twenty weeks of gestation. OBJECTIVES The aim of the present study was to compare maternal circulating levels of endothelial dysfunction mediators, including the vascular actions of adrenomedullin (AM) and calcitonin gene-related peptide (CGRP), the angiogenic factor of soluble intracellular adhesion molecule-1 (sICAM-1) and the pro-oxidant activity factor of total homocysteine (tHcy), in the plasma of normal and pre-eclampsia pregnancies. Furthermore, the authors investigated whether magnesium sulfate therapy is involved in modulating the circulating levels of these four molecules, thus helping to prevent pre-eclampsia. MATERIAL AND METHODS A total of 85 pregnant women were involved in this study, including 30 healthy pregnant women, 15 with pregnancy-induced hypertension (PIH) and 40 with pre-eclampsia (PE). The maternal levels of AM, CGRP, sICAM-1 and tHcy in plasma were determined by enzyme-linked immunoassay (ELISA). Furthermore, the effects of magnesium sulfate therapy on the plasma levels of these four molecules were compared. Results. Compared to healthy pregnancies, maternal circulating concentration of AM, sICAM-1 and tHcy were significantly higher, while the plasma level of CGRP is significantly lower in pregnant women with hypertension or pre-eclampsia (P < 0.05). Magnesium sulfate therapy can effectively suppress the level of AM, sICAM-1 and tHcy, while increasing the level of CGRP in maternal circulation (P < 0.05). CONCLUSIONS Present results indicated that AM, CGRP, sICAM-1 and tHcy may be involved in the development and maintenance of hypertension during pregnancy. By modulating these four mediators, magnesium sulfate may inhibit the progress of pre-eclampsia.